Influence of the Vitamin D Receptor Gene Polymorphism on Bone Loss in Men after Liver Transplantation

  1. Jordi Guardiola, MD;
  2. Xavier Xiol, MD;
  3. Richard Sallie, MD, FRACP;
  4. Joan M. Nolla, MD;
  5. Daniel Roig-Escofet, MD;
  6. Eduardo Jaurrieta, MD; and
  7. Luis Casais, MD
  1. From Ciutat Sanitària i Universitària de Bellvitge, Hospital Princeps d'Espanya, Barcelona, Spain; and National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland.

    Abstract

    Background: Bone loss is a frequent complication after liver transplantation.

    Objective: To investigate whether vitamin D receptor gene polymorphism influences bone loss in men after liver transplantation.

    Design: Prospective cohort study.

    Setting: University hospital.

    Patients: 55 male candidates for liver transplantation.

    Measurements: Lumbar spine bone mineral density was measured before and 3, 6, 12, and 24 months after liver transplantation. Vitamin D receptor genotype was determined by restriction endonuclease BsmI.

    Results: Vitamin D receptor genotypes were significantly associated with post-transplantation changes in bone mineral density (P = 0.028). Within 3 months after transplantation, patients with the genotypes Bb or BB showed a vertebral bone loss substantially greater than that in patients with the bb genotype (between-group difference in the percentage change with respect to baseline bone mineral density, 3.7% [95% CI, 0.6% to 6.9%]). In 3 to 24 months after transplantation, bone mineral density increased steadily in the three allelic groups.

    Conclusions: Vitamin D receptor gene polymorphism influences bone loss after liver transplantation. Patients with the bb genotype are, to some extent, protected against post-transplantation bone loss.

    Article and Author Information

    • Acknowledgments: The authors thank Drs. J. Fiter, J. Escribá, and E. Cabré for technical and statistical assistance.

    • Grant Support: In part by a research grant from the CIRIT (Generalitat de Catalunya) (Dr. Guardiola).

    • Requests for Reprints: Jordi Guardiola, MD, Gastroenterology Unit, Hospital Comarcal de L'Alt Penedès, Espirall s/n, 08720 Vilafranca del Penedès, Barcelona, Spain. For reprint orders in quantities exceeding 100, please contact the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints{at}mail.acponline.org.

    • Current Author Addresses: Dr. Guardiola: Gastroenterology Unit, Hospital Comarcal de L'Alt Penedès, Espirall s/n, 08720 Vilafranca del Penedès, Barcelona, Spain.

    • Drs. Xiol and Casais: Department of Gastroenterology, Ciutat Sanitària i Universitària de Bellvitge, Hospital Princeps d'Espanya, Feixa Llarga s/n, 08907 L'Hopitalet de Llobregat, Barcelona, Spain.

    • Dr. Sallie: The Liver Unit, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Room 4D-52, Building 10, Bethesda, Maryland 20892.

    • Drs. Nolla and Roig-Escofet: Department of Rheumatology, Ciutat Sanitària i Universitària de Bellvitge, Hospital Princeps d'Espanya, Feixa Llarga s/n, 08907 L'Hopitalet de Llobregat, Barcelona, Spain.

    • Dr. Jaurrieta: Department of General Surgery, Ciutat Sanitària i Universitària de Bellvitge, Hospital Princeps d'Espanya, Feixa Llarga s/n, 08907 L'Hopitalet de Llobregat, Barcelona, Spain.

    Summary for Patients

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